<!DOCTYPE html>
<html>
	<head>
		<meta charset="UTF-8">
		<title>申请退款</title>
		<meta name="viewport" content="width=device-width, initial-scale=1.0, maximum-scale=1.0, user-scalable=0">
		<link rel="stylesheet" href="css/style.css" />
		<script type="text/javascript" src="js/resize.js" ></script>
		<script type="text/javascript" src="js/jquery-1.10.1.min.js" ></script>
		<script type="text/javascript" src="js/common.js" ></script>
	</head>
	<body class="bgwhite">
		<div class="wrap">
			<div class="header">
				<div class="warp">
					<a href="javascript:;" class="return-btn fl"></a>
					申请退款
					<a href="javascript:;" class="nav fr" data-click="on"></a>
					<ol class="menu-down">
						<li><a href="index.html">首 页</a></li>
						<li><a href="teacherList.html">教员库</a></li>
						<li><a href="applyfor.html">快速请家教</a></li>
						<li><a href="xueyuanList.html">学员库</a></li>
						<li><a href="parentFeedback.html">家长反馈</a></li>
					</ol>
				</div>
			</div>
			<!--退款提示-->
			<div class="refundTips warp">
				<p>1. 请认真填写如下信息，需要退款的银行的支行一定要写清楚！</p>
				<p>2. 我们会在每周星期三和星期五统一做退款处理。</p>
				<p>3. 退款以后会有短信通知，请及时查收。</p>
			</div>
			<!--表单-->
			<form action="" method="post" class="loginForm msgForm">
				<div class="clearfix">
					<label class="fl">姓&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;名:</label>
					<div class="inputBox fl">
						<input type="text" placeholder="收款方"/>
					</div>
				</div>
				<div class="clearfix inputBoxmt">
					<label class="fl">地&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;址:</label>
					<div class="fl">
						<select class="selectBox">
							<option>重庆市</option>
							<option>北京市</option>
							<option>天津市</option>
						</select>
					</div>
				</div>
				<div class="clearfix inputBoxmt">
					<label class="fl">省/直辖市:</label>
					<div class="fl">
						<select class="selectBox">
							<option>重庆市</option>
							<option>北京市</option>
							<option>天津市</option>
						</select>
					</div>
				</div>
				<div class="clearfix inputBoxmt">
					<label class="fl">开&nbsp;&nbsp;&nbsp;户&nbsp;&nbsp;行:</label>
					<div class="inputBox fl">
						<input type="text" placeholder="收款方"/>
					</div>
				</div>
				<div class="clearfix inputBoxmt">
					<label class="fl">支&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;行:</label>
					<div class="inputBox fl">
						<input type="text" placeholder=""/>
					</div>
				</div>
				<div class="clearfix inputBoxmt">
					<label class="fl">账&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;号:</label>
					<div class="inputBox fl">
						<input type="text" placeholder="汇入收款方"/>
					</div>
				</div>
				<div class="clearfix inputBoxmt">
					<label class="fl">账&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;号:</label>
					<div class="inputBox fl">
						<input type="text" placeholder="重新输入收款方账号"/>
					</div>
				</div>
				<a href="javascript:void(0)" class="loginBtn">提交</a>
			</form>
			
		</div>
		
		<!--底部-->
		<div class="footer">
			<a href="javascript:;" title="返回顶部" class="up-btn" id="back-to-top"></a>
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					<p>copyRight@2017-2018</p>
					<p>版权所有：智必达家教</p>
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						<a href="" class="kf">在线客服</a>
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